The flexion tear drop fracture represents the most severe injury of the cervical spine. It results from severe flexion force (head-on collisions in motor vehicles) and often presents with quadriplegia and loss of anterior column sensation. The involved vertebral body is posteriorly distracted relative to the teardrop fragment which remains attached to the anterior longitudinal ligament. The facets are usually subluxed, resulting in compression upon the spinal cord and severe neurologic injury.

A	Lateral radiograph of the cervical spine. This demonstrates the typical appearance of the flexion tear drop fracture of the C5 vertebral body. Copyright and courtesy of www.regionsem.org.

Links to online textbooks

• Wheeless' Orthopedics: discussion of flexion tear drop fractures

References:

• Kim KS, Chen HH, Russell EJ, Rogers LF: Flexion teardrop fracture of the cervical spine: radiographic characteristics AJR Am J Roentgenol. 1989 Feb;152(2):319-26.           [See related articles]
• Clark CR, Igram CM, el-Khoury GY, Ehara S: Radiographic evaluation of cervical spine injuries Spine. 1988 Jul;13(7):742-7.           [See related articles]

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